A randomized five-year clinical study of a two-step self-etch adhesive with or without selective enamel etching.

The purpose of this study was to evaluate the five-year clinical performance of a two-step self-etch adhesive in non-carious cervical sclerotic lesions with or without selective acid-etching of enamel margins. A total of 104 cervical restorations in 22 patients (46-64 years) were bonded following either self-etch approach (AdheSE non-etch) or a similar application, including selective acid-etching of enamel margins (AdheSE etch), and were restored with resin composite. The restorations were evaluated at baseline and after one, two, three and five-years (84 restorations in 19 patients) according to the USPHS criteria. Data were analyzed using McNemar's test. Cumulative retention rates for the non-etch and etch groups were 82.6% and 86.1% respectively. No significant differences were detected in the retention rates, marginal adaptations at dentin side and secondary caries between the groups. After five-years, the clinical performance of the two-step self-etch adhesive with or without selective acid-etching of enamel margins, was acceptable.

The effect of prophylactic polishing pastes on surface roughness of indirect restorative materials.

The purpose of this study was to evaluate the influence of prophylactic polishing pastes (PPP; Detartrine (DT), Topex (TP)) on surface roughness (R(a)) of indirect composites (IRC; Tescera (TES), Gradia (GRD), and Estenia C&B (EST)), a glass ceramic (Empress 2 layering (E2)), and a leucite reinforced glass ceramic (Empress Esthetic (EE)) with two different (glazed (G); polished (P)) surface preparations. A total of 90 IRC and 120 ceramic discs, 8 mm in diameter and 2 mm thick, were prepared. E2 and EE specimens were randomly divided into two groups (n = 30). One group was glazed (GE2; GEE), while the other group was polished (PE2; PEE) the same as the IRCs. The specimens in each group were subsequently divided into three subgroups: control (C), DT, and TP. R(a) (µm) was evaluated with a profilometer. Data were analyzed by Kruskal Wallis, followed by the Dunn's multiple comparison tests (P < 0.05). DT and TP resulted in significant surface roughening for TES, GRD, and EST, while no significant differences were detected between DT and TP (P > 0.05). PE2 and PEE were not affected by DT or TP (P > 0.05), while GE2 and GEE exhibited significant roughening after TP (P < 0.05). Surface roughness of IRCs and glazed ceramics can be affected by PPP applications.

Surface roughness and morphology of resin composites polished with two-step polishing systems.

The purpose of this study was to investigate surface roughness (Ra) and morphology of supra-nanofilled [Estelite Omega (EO), Estelite ∑ Quick (EQ)], micro-hybrid [Esthet.X HD (EHD), G-aenial (GAE)] and nano-hybrid [Clearfil Majesty Posterior (CMP), Charisma Diamond (CD), Beautifil II (BII)] composites polished with two-step polishing systems [Enhance/PoGo (EP); Venus Supra (VS)]. Composite discs, 30 of each type, were prepared. Each composite group was divided into three subgroups: Mylar (control), EP and VS. Ra was evaluated with profilometer. In each composite group, the control had the lowest Ra. With both polishing systems, EO and EQ had significantly the lowest Ra, whereas CMP and BII had the highest. Except for GAE, CD and BII, the differences in Ra between EP and VS in each composite group were significant, showing smoother surfaces for EP. Supra-nanofilled composites created smoother surfaces than nano-hybrids, and their performance was similar or slightly better than that of micro-hybrids.

Three-year clinical evaluation of a two-step self-etch adhesive with or without selective enamel etching in non-carious cervical sclerotic lesions.

OBJECTIVE: The purpose of this prospective, controlled, randomized study was to evaluate the 3-year clinical performance of a two-step self-etch adhesive (AdheSE, Ivoclar Vivadent; Schaan, Liechtenstein) in non-carious cervical sclerotic lesions with or without selective acid-etching of the enamel margins. MATERIAL AND METHODS: Twenty-two patients (mean age 51.5) having at least two pairs of non-carious cervical sclerotic erosion/attrition/abfraction lesions with incisal or occlusal margins in the enamel and gingival margins in the dentin were included in the study. The two-step self-etch adhesive was applied following either the self-etch approach (AdheSE non-etch, n = 52) or a similar application approach, including prior selective acid-etching of the enamel margins (AdheSE etch, n = 52). Composite resin Point 4 (Kerr Corp; Orange, CA, USA) was used as the restorative material for all 104 restorations. The restorations were evaluated at baseline and after 1, 2, and 3 years, according to the modified USPHS criteria. Data were analyzed using McNemar's test (p < 0.05). RESULTS: The retention rates for AdheSE non-etch were 100 %, 98 %, and 91.5 %; whereas, 100 %, 100 %, and 97.9 % retention rates were recorded for AdheSE etch after 1, 2, and 3 years, respectively. No significant differences were detected between the retention rates, marginal adaptation at the dentin side, secondary caries, and postoperative sensitivity (p > 0.05). A significantly higher number of restorations in AdheSE non-etch group showed clinically acceptable slight marginal discoloration (p = 0.0001) and clinically acceptable small marginal defects at the enamel side (p = 0.008) than in the AdheSE etch group. CONCLUSIONS: After 3 years, the two-step self-etch adhesive exhibited acceptable clinical performance with or without selective enamel etching in non-carious cervical sclerotic lesions. CLINICAL RELEVANCE: Selective acid-etching of the enamel margins enhanced the performance of the two-step self-etch adhesive in terms of marginal discoloration and marginal adaptation at the enamel side.

Clinical evaluation of posterior composite restorations in endodontically treated teeth.

OBJECTIVE: The purpose of this study was to evaluate the two year clinical performance of posterior composite restorations in endodontically treated premolars and molars using a hybrid composite (Filtek Z-250, 3M ESPE) and a total etch bonding system (Single Bond, 3M ESPE). METHOD AND MATERIALS: Thirty-nine class II restorations in endodontically treated premolars (n=11) and molars (n=28) of 27 patients (14 female, 13 male, mean age 36.51) in 16 maxillar and 23 mandibular teeth were placed by one operator. Restorations were evaluated by two experienced investigators at baseline, 12 months, and 24 months according to the modified United States Public Health Service (USPHS) criteria that included retention, color match, marginal discoloration, secondary caries, anatomic form, marginal adaptation, and surface texture. All restorations were able to be evaluated at baseline, 12 months, and 24 months. RESULTS: Paired samples t-test showed only marginal discoloration showed a statistically significant difference (p<0.05) at the end of 24 months, and no other significant differences were observed for the other variables examined over the duration of the study. None of the restored teeth showed periapical pathology at the end of 24 months. CONCLUSION: At two years, limited deterioration in marginal discoloration was detected. The clinical performance of posterior composite restorations in endodontically treated teeth using Filtek Z250 was found clinically acceptable after two years.

Microtensile bond strength of a filled vs unfilled adhesive to dentin using self-etch and total-etch technique.

OBJECTIVE: The purpose of this study was to evaluate the effect of a filled adhesive (One-Step Plus; Bisco) versus an unfilled adhesive (One-Step; Bisco) on the microtensile bond strength (muTBS) to dentin using total-etch (Uni-etch; Bisco) and self-etch (Tyrian SPE; Bisco) techniques. METHODS: Twenty extracted human third molars were ground flat to expose occlusal dentin. After the dentin surfaces were polished with 600-grit SiC paper, the teeth were randomly assigned to four groups according to the bonding agent and technique being used. Dentin surfaces were bonded with One-Step Plus+total-etch; One-Step Plus+self-etch; One-Step+total-etch and One-Step+self-etch. Composite buildups were performed with Clearfil AP-X (Kuraray Medical). Following storage in distilled water at 37 degrees C for 24 h, the bonded specimens were serially sectioned into 0.7 mm-thick slabs and then trimmed to hour-glass shapes with a 1 mm2 cross-sectional area (n=20). Microtensile bond strengths were determined using the EZ-test (Shimadzu) at a cross-head speed of 1 mm/min. Data were analyzed using two-way ANOVA and Tukey's post hoc test. RESULTS: There were no significant differences in the muTBS between One-Step Plus and One-Step adhesives when they were used with the total-etch and self-etch techniques (p>0.05). However with the total-etch technique both adhesives yielded significantly higher bond strength values than the self-etch technique (p<0.001). CONCLUSION: The filled adhesive One-Step Plus did not show any beneficial effect than the unfilled adhesive One-Step on the muTBS to dentin with total-etch and self-etch techniques. Irrespective from the adhesive type, self-etch technique revealed lower bond strengths than the total-etch technique.